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This document is a Physical Examination Report that includes sections for pre-employment and annual examinations, immunizations, tuberculosis screening, and declination of influenza vaccination for healthcare personnel. It requires personal and health information, physical examination results, and physician signatures.
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How to fill out physical examination report

How to fill out physical examination report
01
Begin with personal information: Include the patient's name, date of birth, and identification number.
02
Document the date of the examination: Ensure to note when the examination was conducted.
03
Include the reason for the examination: State if it was for a routine check-up, pre-employment, or other specific reasons.
04
Perform a comprehensive medical history: Record the patient's medical history, including any past conditions or surgeries.
05
Conduct vital signs assessment: Measure and note the patient's blood pressure, pulse, temperature, and respiratory rate.
06
Perform a physical examination: Systematically examine each body system (e.g., cardiovascular, respiratory, gastrointestinal) and document findings.
07
Note any abnormalities: Clearly indicate if there are any significant health issues or concerns identified during the examination.
08
Include any necessary diagnostic tests: Record results from lab tests, imaging, or other assessments performed.
09
Provide recommendations: Offer health advice, follow-up and treatment plans based on examination findings.
10
Sign and date the report: Ensure the report is completed with the examiner's signature and the date of completion.
Who needs physical examination report?
01
Patients undergoing routine health checks.
02
Individuals applying for jobs that require a health assessment.
03
Athletes needing a sports physical examination.
04
Individuals seeking health insurance that requires a physical exam report.
05
Patients involved in legal matters requiring medical documentation.
06
Students applying for schools that require health clearance.
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What is physical examination report?
A physical examination report is a document that summarizes the findings from a medical examination conducted by a healthcare professional to assess a person's health status.
Who is required to file physical examination report?
Typically, individuals involved in specific activities such as athletes, certain job applicants, or patients undergoing medical assessments are required to file a physical examination report.
How to fill out physical examination report?
To fill out a physical examination report, provide personal information, document the reason for the exam, detail the physical findings, include any necessary laboratory results, and ensure that it is signed by the examining healthcare professional.
What is the purpose of physical examination report?
The purpose of a physical examination report is to document the results of a health evaluation, establish a baseline for future health assessments, and provide necessary information for medical treatment or compliance with occupational health requirements.
What information must be reported on physical examination report?
A physical examination report must include the patient's personal information, medical history, the results of the physical examination, vital signs, any laboratory test results, and the conclusion or recommendations by the healthcare provider.
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